NPI Code Detail JSON Logo

1982615977 NPI number — TERI K. WHITTAKER I OD

NPI Number: 1982615977
Health Care Provider/Practitioner: TERI K. WHITTAKER I OD

Information about “1982615977” NPI (TERI K. WHITTAKER I OD) exists in 1982615977 in HTML format HTML  |  1982615977 in plain Text format TXT  |  1982615977 in PDF (Portable Document Format) PDF  |  1982615977 in an XML format XML  formats.

NPI Number : 1982615977 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1982615977",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WHITTAKER",
    "FirstName": "TERI",
    "MiddleName": "K.",
    "NamePrefix": null,
    "NameSuffix": "I",
    "Credential": "OD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "11225 HURON LN STE 200A",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LITTLE ROCK",
    "MailingAddressStateName": "AR",
    "MailingAddressPostalCode": "72211-1861",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "501-653-2020",
    "MailingAddressFaxNumber": "501-653-7407",
    "FirstLinePracticeLocationAddress": "2900 HORIZON DR STE 15",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BRYANT",
    "PracticeLocationAddressStateName": "AR",
    "PracticeLocationAddressPostalCode": "72022-9095",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "504-653-2020",
    "PracticeLocationAddressFaxNumber": "501-653-7407",
    "EnumerationDate": "08/11/2006",
    "LastUpdateDate": "06/25/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "152W00000X",
        "TaxonomyName": "Optometrist",
        "LicenseNumber": "2573",
        "LicenseNumberStateCode": "AR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.